TEDxMet
Andrew Solomon: Depression, the secret we share
安德魯．索羅門 (Andrew Solomon): 憂鬱，我們共享的秘密
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「憂鬱的反面不是快樂，而是活力，那段時間活力似乎從我身上慢慢消失了。」在這場具有說服力和顛覆性的演說中，安德魯．索羅門 (Andrew Solomon) 帶你走進他與憂鬱對抗多年時內心最陰暗的角落。這段經歷開啟了他到世界各地採訪憂鬱患者的驚奇旅程。出乎意料的是，他發現當自己說得越多，就會有越多人想述說他們自己的故事。（攝於 TEDxMet）
Double-click the English transcript below to play the video.
00:15
"I felt a funeral in my brain,
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「在我的腦海中，有一場葬禮，
00:19
and mourners to and fro
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哀悼者來來去去，
00:22
kept treading, treading till I felt
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不停踩踏，踩踏，直到我感覺
00:24
that sense was breaking through.
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感官衝破了覺知。
00:27
And when they all were seated,
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當眾人全都就座，
00:29
a service, like a drum,
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儀式開始，像擊鼓般，
00:31
kept beating, beating, till I felt
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不斷敲擊、敲擊，直到感覺
00:34
my mind was going numb.
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我的意識就此麻木。
00:37
And then I heard them lift a box
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此刻我聽見他們抬起棺木，
00:39
and creak across my soul
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嘰嘎聲穿透我的魂。
00:41
with those same boots of lead again,
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鉛靴的踏步聲再度揚起，
00:45
then space began to toll,
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伴隨喪鐘迴盪，
00:48
as if the heavens were a bell
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彷彿天空是具大鐘，
00:50
and being were an ear,
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只剩下一只耳朵存在，
00:52
and I, and silence, some strange race
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而我與寂靜間，一場微妙的追逐，
00:55
wrecked, solitary, here.
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獨自在此破碎。
00:58
Just then, a plank in reason broke,
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就在此時，理性忽然斷了弦，
01:01
and I fell down and down
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我不斷墜落，
01:05
and hit a world at every plunge,
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每次墜落都撞上一個世界，
01:07
and finished knowing then."
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最終豁然開朗。 」
01:12
We know depression through metaphors.
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我們透過文學隱喻認識了憂鬱。
01:15
Emily Dickinson was able to convey it in language,
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艾蜜莉．狄更生（十九世紀美國詩人）
用詩歌描寫它，
用詩歌描寫它，
01:19
Goya in an image.
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哥雅（西班牙畫家）用繪畫詮釋，
01:22
Half the purpose of art
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半數藝術品的目的
01:24
is to describe such iconic states.
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是為了描述這象徵性的狀態。
01:27
As for me, I had always thought myself tough,
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對我而言，我總把自己看做一名鬥士，
01:31
one of the people who could survive
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是那種即使被送往集中營
01:33
if I'd been sent to a concentration camp.
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也可以存活下來的人。
01:36
In 1991, I had a series of losses.
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1991 年，我經歷了一連串的不幸。
01:39
My mother died,
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我的母親去世，
01:41
a relationship I'd been in ended,
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戀情終結，
01:43
I moved back to the United States
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多年居住外國之後，
01:45
from some years abroad,
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我返回了美國。
01:47
and I got through all of those experiences intact.
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我安然無恙地經歷這一切。
01:50
But in 1994, three years later,
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但是到了 1994 年，即三年之後，
01:53
I found myself losing interest in almost everything.
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我發現自己對所有的事情都失去了興趣。
01:57
I didn't want to do any of the things
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任何我曾經喜歡做的事情，
01:59
I had previously wanted to do,
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我都不願意做。
02:01
and I didn't know why.
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對此我毫無頭緒。
02:03
The opposite of depression
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憂鬱的反面
02:05
is not happiness, but vitality,
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不是快樂，而是活力。
02:08
and it was vitality
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正是這種活力，
02:10
that seemed to seep away from me in that moment.
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在那時似乎從我體內一點一點地消失。
02:14
Everything there was to do
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任何需要做的事情
02:16
seemed like too much work.
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都變得困難無比。
02:18
I would come home
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我回到家裡，
02:20
and I would see the red light
flashing on my answering machine,
flashing on my answering machine,
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看到答錄機上閃爍跳躍的紅燈，
02:23
and instead of being thrilled to hear from my friends,
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我非但不會因為有朋友的音訊而感到興奮。
02:25
I would think,
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我會想著：
02:27
"What a lot of people that is to have to call back."
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「怎麼有這麼多人需要我回覆電話！」
02:30
Or I would decide I should have lunch,
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又比如，我知道自己該吃午餐了。
02:32
and then I would think, but
I'd have to get the food out
I'd have to get the food out
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我就會想，我需要把食物取出來，
02:35
and put it on a plate
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放在盤子上，
02:37
and cut it up and chew it and swallow it,
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切開它們，嚼碎它們再嚥下去。
02:41
and it felt to me like the Stations of the Cross.
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這對我就像耶穌受難一樣難熬。
02:45
And one of the things that often gets lost
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有關憂鬱的討論中，
02:47
in discussions of depression
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有一點經常讓人困惑，
02:49
is that you know it's ridiculous.
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那就是你明白這一切都很荒謬。
02:51
You know it's ridiculous while you're experiencing it.
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當你經歷這一切的時候，
你知道這很荒謬。
你知道這很荒謬。
02:54
You know that most people manage
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你知道大多數人能夠
02:56
to listen to their messages and eat lunch
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聽他們的電話留言、吃午飯、
02:58
and organize themselves to take a shower
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打點好自己、沖個澡，
03:00
and go out the front door
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然後走出大門。
03:02
and that it's not a big deal,
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這些事無關緊要，
03:03
and yet you are nonetheless in its grip
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但你卻依然深陷其中，
03:06
and you are unable to figure out any way around it.
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你無法找到逃離的方式。
03:10
And so I began to feel myself doing less
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於是我發現自己做的事越來越少，
03:15
and thinking less
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思考愈來愈少，
03:17
and feeling less.
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感覺越來越少，
03:19
It was a kind of nullity.
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處在一種虛無狀態中。
03:22
And then the anxiety set in.
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這時焦慮出現了。
03:24
If you told me that I'd have to be
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如果你告訴我，
我會在下個月一直憂鬱，
03:26
depressed for the next month,
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03:28
I would say, "As long I know it'll be
over in November, I can do it."
over in November, I can do it."
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我會說：「只要我知道，
憂鬱會在 11 月消失，我就能挺過去。」
憂鬱會在 11 月消失，我就能挺過去。」
03:31
But if you said to me,
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然而如果你這樣說：
03:32
"You have to have acute anxiety for the next month,"
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「你會在下個月嚴重焦慮。」
03:35
I would rather slit my wrist than go through it.
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我寧願割腕也不願意承受。
03:38
It was the feeling all the time
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這是一種持續的感受，
03:40
like that feeling you have if you're walking
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就好像你走在路上，
03:42
and you slip or trip
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你跌倒了或者絆倒了，
03:43
and the ground is rushing up at you,
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地面猛然衝向你。
03:45
but instead of lasting half a
second, the way that does,
second, the way that does,
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但是這感覺不是只有半秒，
03:48
it lasted for six months.
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這感覺要持續六個月。
03:50
It's a sensation of being afraid all the time
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這是一種無時無刻感到害怕，
03:53
but not even knowing what it is that you're afraid of.
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卻不知道你在害怕什麼的感覺。
03:57
And it was at that point that I began to think
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那一刻我開始想，
03:59
that it was just too painful to be alive,
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活著太痛苦了。
04:03
and that the only reason not to kill oneself
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人不會自殺的唯一理由，
04:06
was so as not to hurt other people.
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就是不想傷害旁人。
04:09
And finally one day, I woke up
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終於有一天，我醒來，
04:12
and I thought perhaps I'd had a stroke,
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我想我可能中風了。
04:14
because I lay in bed completely frozen,
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因為我躺在床上，渾身僵硬。
04:16
looking at the telephone, thinking,
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我看著電話，心想：
04:18
"Something is wrong and I should call for help,"
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「出事了，我應該打電話求救。」
04:22
and I couldn't reach out my arm
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我卻無法伸出胳膊，
04:24
and pick up the phone and dial.
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無法拿起電話撥號，
04:26
And finally, after four full hours
of my lying and staring at it,
of my lying and staring at it,
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終於，在我躺著盯著電話
整整四個小時之後，
整整四個小時之後，
04:30
the phone rang,
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電話響了。
04:32
and somehow I managed to pick it up,
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不知怎麼我拿起了聽筒，
04:34
and it was my father,
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那是我父親來電。
04:36
and I said, "I'm in serious trouble.
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我說：「我麻煩大了，
04:39
We need to do something."
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我們必須做點什麼。 」
04:41
The next day I started with the medications
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第二天我開始接受藥物治療
04:44
and the therapy.
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和心理治療。
04:47
And I also started reckoning
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並且我開始思索
04:49
with this terrible question:
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這個可怕的問題：
04:51
If I'm not the tough person
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如果我不是個堅強的人，
04:53
who could have made it
through a concentration camp,
through a concentration camp,
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不是那種可以在集中營裡存活的人，
04:56
then who am I?
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那麼我是誰？
04:57
And if I have to take medication,
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如果我必須服用藥物，
04:59
is that medication making me more fully myself,
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那麼藥物是讓我變得更像我自己，
05:03
or is it making me someone else?
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還是讓我變成了別人？
05:05
And how do I feel about it
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我要如何知道
05:07
if it's making me someone else?
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藥物是否讓我變成了別人呢？
05:09
I had two advantages as I went in to the fight.
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在這場戰鬥中我有兩個優勢：
05:13
The first is that I knew that, objectively speaking,
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第一，我很清楚，客觀地說，
05:16
I had a nice life,
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我有很好的生活。
05:17
and that if I could only get well,
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一旦我好起來，
05:19
there was something at the other end
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還會有一些東西
05:21
that was worth living for.
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值得我去追求。
05:23
And the other was that I had
access to good treatment.
access to good treatment.
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另外一點是我能接受很好的治療。
05:26
But I nonetheless emerged and relapsed,
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然而我卻反覆發作，
05:29
and emerged and relapsed,
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好轉又發作，
05:32
and emerged and relapsed,
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又一次好轉，再發作。
05:35
and finally understood
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終於我明白，
05:37
I would have to be on medication
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自己必須一輩子
05:39
and in therapy forever.
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服藥和治療。
05:41
And I thought, "But is it a chemical problem
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於是我想：「但是這到底是化學問題
05:44
or a psychological problem?
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還是心理問題？
05:45
And does it need a chemical cure
or a philosophical cure?"
or a philosophical cure?"
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是需要化學療法還是哲學療法？」
05:49
And I couldn't figure out which it was.
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我想不出是哪一種。
05:51
And then I understood that actually,
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接著我懂了，
事實上，我們對這兩個領域的了解
05:54
we aren't advanced enough in either area
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05:56
for it to explain things fully.
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都不足以完全解釋真相。
05:58
The chemical cure and the psychological cure
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化學療法和心理療法都有
06:01
both have a role to play,
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各自的作用。
06:03
and I also figured out that depression was something
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同時我明白了憂鬱是一種
06:06
that was braided so deep into us
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深深根植於我們體內的東西。
06:09
that there was no separating it
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我們無法從性格和個性中
06:10
from our character and personality.
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將憂鬱剝離開來。
06:13
I want to say that the treatments we have
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我想說我們對憂鬱的治療
06:15
for depression are appalling.
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方法太過恐怖。
06:17
They're not very effective.
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這些方法不太有效，
06:19
They're extremely costly.
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而且代價高昂，
06:21
They come with innumerable side effects.
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還帶來無數副作用，
06:24
They're a disaster.
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簡直就是場災難。
06:25
But I am so grateful that I live now
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不過我很慶幸自己活在現代，
06:28
and not 50 years ago,
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而不是 50 年前，
06:30
when there would have been almost nothing
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那時候幾乎沒有任何
06:32
to be done.
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治療的辦法。
06:33
I hope that 50 years hence,
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我想 50 年以後，
06:36
people will hear about my treatments
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人們聽說我的治療方法，
06:37
and be appalled that anyone endured
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會驚訝於居然有人能忍受
06:40
such primitive science.
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如此原始粗糙的科學。
06:42
Depression is the flaw in love.
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憂鬱是愛的缺陷。
06:47
If you were married to someone and thought,
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如果你將要和另一半結婚，然後想：
06:50
"Well, if my wife dies, I'll find another one,"
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「好吧，如果我妻子死了，我會再找一個。」
06:54
it wouldn't be love as we know it.
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這不是我們熟知的愛情。
06:57
There's no such thing as love
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沒有這樣一種愛情，
06:59
without the anticipation of loss,
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只有獲取幸福卻不用體驗失去。
07:01
and that specter of despair
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這種絕望的幽靈，
07:04
can be the engine of intimacy.
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會是親密關係的動力。
07:08
There are three things people tend to confuse:
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人們容易混淆三件事：
07:11
depression, grief and sadness.
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憂鬱，悲傷和難過。
07:14
Grief is explicitly reactive.
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悲傷是明確的反應。
07:18
If you have a loss and you feel incredibly unhappy,
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如果你因為損失而感到非常不開心，
07:21
and then, six months later,
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那麼六個月之後，
07:22
you are still deeply sad, but
you're functioning a little better,
you're functioning a little better,
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你仍然很難過，但日常作息好轉了一些。
07:25
it's probably grief,
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這大概就是悲傷。
07:27
and it will probably ultimately resolve itself
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它可能最終在一定程度上
07:29
in some measure.
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能自行修復。
07:31
If you experience a catastrophic loss,
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如果你經歷了一次災難性的打擊，
07:34
and you feel terrible,
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你感覺非常糟糕，
07:35
and six months later you can barely function at all,
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六個月之後依然無法正常生活，
07:38
then it's probably a depression that was triggered
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那麼可能就是一種憂鬱
07:40
by the catastrophic circumstances.
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被災難性的情形所觸發了。
07:43
The trajectory tells us a great deal.
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這個分析軌跡告訴我們很多訊息。
07:47
People think of depression as being just sadness.
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人們認為憂鬱只是難過。
07:50
It's much, much too much sadness,
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只是太多太多的難過，
07:52
much too much grief
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太多太多的悲傷，
07:54
at far too slight a cause.
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因為微不足道的事情而起。
07:57
As I set out to understand depression,
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當我開始了解憂鬱，
08:00
and to interview people who had experienced it,
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採訪了經歷過憂鬱的人們，
08:02
I found that there were people who seemed
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3031
我發現有些人
表面上看起來
08:05
on the surface to have what sounded like
184
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1705
似乎有輕微的憂鬱，
08:07
relatively mild depression
185
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2062
08:09
who were nonetheless utterly disabled by it.
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3447
他們卻因此完全喪失了行為能力。
08:13
And there were other people who had what sounded
187
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1858
另外一些人，
08:15
as they described it
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1312
根據他們的描述，
08:16
like terribly severe depression
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2251
有非常嚴重的憂鬱，
08:18
who nonetheless had good lives in the interstices
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卻能在憂鬱的間隙
08:21
between their depressive episodes.
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過著不錯的生活。
08:23
And I set out to find out what it is
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我開始著手研究，
08:26
that causes some people
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為什麼有些人
08:27
to be more resilient than other people.
194
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比另一些人有更好的復元能力。
08:30
What are the mechanisms
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是什麼機制
08:31
that allow people to survive?
196
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讓人得以倖存？
08:33
And I went out and I interviewed person after person
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我出去採訪了一個又一個
08:36
who was suffering with depression.
198
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因憂鬱而受苦的人。
08:38
One of the first people I interviewed
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我最早採訪的某個人
08:40
described depression
200
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1881
將憂鬱描述為
08:42
as a slower way of being dead,
201
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一種緩慢的死亡方式。
08:45
and that was a good thing for me to hear early on
202
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2124
最初就聽到這說法對我來說是好事，
08:48
because it reminded me
203
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1366
因為它提醒了我
08:49
that that slow way of being dead
204
517457
1999
緩慢的死亡
08:51
can lead to actual deadness,
205
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2035
可以通往真正的死亡。
08:53
that this is a serious business.
206
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2004
這可是正經話。
08:55
It's the leading disability worldwide,
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2659
憂鬱是世界上名列前茅的身心障礙，
08:58
and people die of it every day.
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每天都有人因此喪生。
09:01
One of the people I talked to
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1769
當我試著了解這些的時候，
09:02
when I was trying to understand this
210
530953
1974
我的一位採訪對象，
09:04
was a beloved friend
211
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1668
也是我的摯友，
09:06
who I had known for many years,
212
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2018
我與她相識多年。
09:08
and who had had a psychotic episode
213
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2542
在她大一的時候，
09:11
in her freshman year of college,
214
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1904
有過一次精神病發作，
09:13
and then plummeted into a horrific depression.
215
541059
3056
之後她陷入了可怕的憂鬱。
09:16
She had bipolar illness,
216
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1426
她患有雙相障礙，
09:17
or manic depression, as it was then known.
217
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2643
當時也稱為躁鬱症。
09:20
And then she did very well
218
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2044
經過多年的鋰治療，
09:22
for many years on lithium,
219
550228
1708
她恢復得不錯。
09:23
and then eventually,
220
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1375
於是到最後，
09:25
she was taken off her lithium
221
553311
1960
她停止了化學治療，
09:27
to see how she would do without it,
222
555271
1835
看看自己不治療能撐多久。
09:29
and she had another psychosis,
223
557106
1975
然而她的精神病復發，
09:31
and then plunged into the worst depression
224
559081
2338
接著陷入了我所見過
09:33
that I had ever seen
225
561419
1872
最嚴重的憂鬱。
09:35
in which she sat in her parents' apartment,
226
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3015
她坐在父母的公寓裡，
09:38
more or less catatonic, essentially without moving,
227
566306
3077
多少有點緊張型精神分裂症，
幾乎一動也不動，
幾乎一動也不動，
09:41
day after day after day.
228
569383
2482
就這樣過了一天又一天。
09:43
And when I interviewed her about
that experience some years later --
that experience some years later --
229
571865
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多年後我採訪她，談起了這段經歷──
09:47
she's a poet and psychotherapist
named Maggie Robbins —
named Maggie Robbins —
230
575082
3331
她叫瑪姬．羅賓 (Maggie Robbins) ，
是一位詩人和精神治療師──
是一位詩人和精神治療師──
09:50
when I interviewed her, she said,
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3233
當我採訪她時，她說：
09:53
"I was singing 'Where Have All The Flowers Gone'
232
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3384
「 當時我一遍一遍地唱著
《花兒都去哪兒了》，
《花兒都去哪兒了》，
09:57
over and over to occupy my mind.
233
585030
3210
滿腦子都是這首歌。
10:00
I was singing to blot out the
things my mind was saying,
things my mind was saying,
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3135
我唱著歌來清除腦子裡的那個聲音，
10:03
which were, 'You are nothing. You are nobody.
235
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那個聲音說：『你什麼都不是，你一文不名。
10:07
You don't even deserve to live.'
236
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2826
你不配活著。』
10:10
And that was when I really started thinking
237
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2178
從那一刻起，我真的開始想要
10:12
about killing myself."
238
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2213
殺死我自己。 」
10:15
You don't think in depression
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1908
你憂鬱的時候，並不像是
10:16
that you've put on a gray veil
240
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2137
你戴上了一個灰色面紗，
10:19
and are seeing the world through the haze
241
607127
1980
透過沮喪情緒的霧霾
10:21
of a bad mood.
242
609107
1894
來看待這個世界。
10:23
You think that the veil has been taken away,
243
611001
2720
而是你認為那層快樂的面紗
10:25
the veil of happiness,
244
613721
1922
已經被拿走，
10:27
and that now you're seeing truly.
245
615643
2424
所以現在你面對的是赤裸裸的現實。
10:30
It's easier to help schizophrenics who perceive
246
618067
2964
幫助精神分裂症患者相對容易一些，
10:33
that there's something foreign inside of them
247
621031
1811
他們知道身體裡有異物，
10:34
that needs to be exorcised,
248
622842
2187
需要把它們弄出去。
10:37
but it's difficult with depressives,
249
625029
2164
而對於憂鬱症患者就困難多了，
10:39
because we believe we are seeing the truth.
250
627193
3847
因為我們相信自己看到的是現實。
10:43
But the truth lies.
251
631040
2947
但是事實會說謊。
10:45
I became obsessed with that sentence:
252
633987
1998
我為這句話著迷：
10:47
"But the truth lies."
253
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2375
「事實會說謊。」
10:50
And I discovered, as I talked to depressive people,
254
638360
2453
據我觀察，當我和憂鬱症患者交談時，
10:52
that they have many delusional perceptions.
255
640813
2682
他們有許多妄想的念頭。
10:55
People will say, "No one loves me."
256
643495
1667
他們會說：「沒人愛我。」
10:57
And you say, "I love you,
257
645162
1651
你會說：「我愛你，
10:58
your wife loves you, your mother loves you."
258
646813
2522
你的妻子愛你，你的媽媽愛你。」
11:01
You can answer that one pretty readily,
259
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1923
你可以馬上說出這個答案，
11:03
at least for most people.
260
651258
1665
至少大多數人是這樣。
11:04
But people who are depressed will also say,
261
652923
2267
但是憂鬱症患者還會說：
11:07
"No matter what we do,
262
655190
1705
「不管我們做什麼，
11:08
we're all just going to die in the end."
263
656895
2273
最終，我們都會死去。」
11:11
Or they'll say, "There can be no true communion
264
659168
2203
或者他們會說：「人與人之間
11:13
between two human beings.
265
661371
1653
不可能有真正的交流。
11:15
Each of us is trapped in his own body."
266
663024
2576
我們每個人都被困在自己的身體裡。」
11:17
To which you have to say,
267
665600
1849
關於這點你會反駁說：
11:19
"That's true,
268
667449
1321
「這沒錯，
11:20
but I think we should focus right now
269
668770
1818
但是我認為，我們當下應該考慮的是
11:22
on what to have for breakfast."
270
670588
1896
早飯吃什麼。」
11:24
(Laughter)
271
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2185
（笑聲）
11:26
A lot of the time,
272
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1669
大多數時候，
11:28
what they are expressing is not illness, but insight,
273
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2896
他們所表現出來的不是病症，而是思想偏執。
11:31
and one comes to think what's really extraordinary
274
679234
2657
他們對這些問題特別在意，
11:33
is that most of us know about
those existential questions
those existential questions
275
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2934
而大多數人都知道這些存在主義問題，
11:36
and they don't distract us very much.
276
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2290
但是我們不會太困擾。
11:39
There was a study I particularly liked
277
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2159
我特別喜歡這個研究：
11:41
in which a group of depressed
278
689274
1680
一群憂鬱症患者
11:42
and a group of non-depressed people
279
690954
1901
和一群非憂鬱症患者
11:44
were asked to play a video game for an hour,
280
692855
2623
被要求玩一個小時的電玩。
11:47
and at the end of the hour,
281
695478
1813
一小時後問他們，
11:49
they were asked how many little monsters
282
697291
1651
他們認為自己
11:50
they thought they had killed.
283
698942
1864
殺死了多少只小怪獸。
11:52
The depressive group was usually accurate
284
700806
2212
憂鬱症組的回答通常是準確的，
11:55
to within about 10 percent,
285
703018
2058
誤差在 10％ 以內。
11:57
and the non-depressed people
286
705076
1471
而非憂鬱症組的人，
11:58
guessed between 15 and 20 times as many
287
706547
3545
回答打死小怪獸的數量
12:02
little monsters — (Laughter) —
288
710092
1742
比實際數目
12:03
as they had actually killed.
289
711834
4111
多了 15 到 20 倍 。
──（笑聲）──
──（笑聲）──
12:07
A lot of people said, when I chose
to write about my depression,
to write about my depression,
290
715945
3066
當我選擇寫下我自己的憂鬱經歷，很多人說
12:11
that it must be very difficult
291
719011
1769
要揭開這個秘密，讓別人知道，
12:12
to be out of that closet, to have people know.
292
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3124
一定非常困難。
12:15
They said, "Do people talk to you differently?"
293
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2200
他們說：「人們會用不同的口吻和你說話嗎？」
12:18
And I said, "Yes, people talk to me differently.
294
726104
2072
我回答：「是的，人們用不一樣的語氣和我說話。
12:20
They talk to me differently insofar
295
728176
1914
這種不一樣表現在
12:22
as they start telling me about their experience,
296
730090
2790
他們會開始和我談自己的經歷，
12:24
or their sister's experience,
297
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1835
或者他們姐妹的經歷，
12:26
or their friend's experience.
298
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1774
或者他們朋友的經歷。
12:28
Things are different because now I know
299
736489
2292
事情和以前有所不同，因為現在我知道
12:30
that depression is the family secret
300
738781
2681
憂鬱是每個家庭裡的秘密。
12:33
that everyone has.
301
741462
2077
12:35
I went a few years ago to a conference,
302
743539
3628
幾年前我參加一個會議，
12:39
and on Friday of the three-day conference,
303
747167
2653
會議有三天，這天是週五。
12:41
one of the participants took me aside, and she said,
304
749820
2891
一名與會者把我拉到一旁，對我說：
12:44
"I suffer from depression and
305
752711
3405
「我有憂鬱症，
12:48
I'm a little embarrassed about it,
306
756116
2769
我覺得有點不好意思，
12:50
but I've been taking this medication,
307
758885
2103
但是我一直在服這種藥，
12:52
and I just wanted to ask you what you think?"
308
760988
2948
我只想問問你的意見？」
12:55
And so I did my best to give
her such advice as I could.
her such advice as I could.
309
763936
2834
於是我盡我所能給了她一些建議。
12:58
And then she said, "You know,
310
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1720
然後她說：「你知道，
13:00
my husband would never understand this.
311
768490
2791
我丈夫永遠不會理解這些。
13:03
He's really the kind of guy to whom
this wouldn't make any sense,
this wouldn't make any sense,
312
771281
2573
他就是那種認為這些都是胡說八道的人，
13:05
so I just, you know, it's just between us."
313
773854
2867
所以我想，嗯，希望我們的談話能保密。」
13:08
And I said, "Yes, that's fine."
314
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1786
我回答：「當然沒問題。」
13:10
On Sunday of the same conference,
315
778507
2109
週日在同一個會議上，
13:12
her husband took me aside,
316
780616
3044
她的丈夫把我拉到一邊，
13:15
and he said, "My wife wouldn't think
317
783660
1694
他說：「我妻子如果知道這事，
13:17
that I was really much of a guy if she knew this,
318
785354
2435
她就不會覺得我是個男子漢，
13:19
but I've been dealing with this depression
319
787789
2466
但是我一直在對抗憂鬱，
13:22
and I'm taking some medication,
320
790255
1354
而且在服用藥物，
13:23
and I wondered what you think?"
321
791609
2505
我想能否聽聽你的建議？」
13:26
They were hiding
322
794114
1423
他們兩個
13:27
the same medication in two different places
323
795537
2215
把同樣的藥物藏在
13:29
in the same bedroom.
324
797752
2645
臥室不同的地方。
13:32
And I said that I thought
325
800397
2021
於是我對他說，
13:34
communication within the marriage
326
802418
1684
我認為婚姻中的溝通
13:36
might be triggering some of their problems.
327
804102
2014
可能引起他們的某些問題。
13:38
(Laughter)
328
806116
4191
（笑聲）
13:42
But I was also struck
329
810307
1655
不過我也震驚於
13:43
by the burdensome nature
330
811962
1806
這種相互隱瞞的
13:45
of such mutual secrecy.
331
813768
2373
惱人天性。
13:48
Depression is so exhausting.
332
816141
1885
憂鬱令人精疲力盡，
13:50
It takes up so much of your time and energy,
333
818026
2768
它消耗了你那麼多的時間和精力。
13:52
and silence about it,
334
820794
1504
對此緘口不提，
13:54
it really does make the depression worse.
335
822298
2731
只會讓憂鬱更糟糕。
13:57
And then I began thinking about all the ways
336
825029
1733
我開始考慮各種方法
13:58
people make themselves better.
337
826762
1966
可以讓人們感覺更好。
14:00
I'd started off as a medical conservative.
338
828728
2439
一開始我對醫學治療較保守。
14:03
I thought there were a few
kinds of therapy that worked,
kinds of therapy that worked,
339
831167
2372
我認為一些療法是有效的，
14:05
it was clear what they were --
340
833539
1809
它們確實有效──
14:07
there was medication,
341
835348
1644
包括藥物治療，
14:08
there were certain psychotherapies,
342
836992
1476
還有一些特定的心理治療，
14:10
there was possibly electroconvulsive treatment,
343
838468
2445
電痙攣療法也可能有效。
14:12
and that everything else was nonsense.
344
840913
2675
除此以外的都沒用。
14:15
But then I discovered something.
345
843588
1832
但是後來我發現，
14:17
If you have brain cancer,
346
845420
1752
如果你得了腦癌，
14:19
and you say that standing on your head
347
847172
1472
而且你認為每天早上
14:20
for 20 minutes every morning makes you feel better,
348
848644
2995
倒立 20 分鐘能讓你感覺好些，
14:23
it may make you feel better,
349
851639
1514
這可能讓你感覺好一些，
14:25
but you still have brain cancer,
350
853153
1588
但是你仍然會有腦癌。
14:26
and you'll still probably die from it.
351
854741
2289
你還是有可能因此死去。
14:29
But if you say that you have depression,
352
857030
2512
不過如果你說你得了憂鬱症，
14:31
and standing on your head for 20 minutes every day
353
859542
2105
然後每天倒立 20 分鐘
14:33
makes you feel better, then it's worked,
354
861647
2484
讓你感覺好些，那麼這是有效的。
14:36
because depression is an illness of how you feel,
355
864131
2360
因為憂鬱是一種關於感受的疾病。
14:38
and if you feel better,
356
866491
1609
如果你感覺好一點了，
14:40
then you are effectively not depressed anymore.
357
868100
2830
那麼你就不會那麼憂鬱了。
14:42
So I became much more tolerant
358
870930
2033
所以我開始對無數的替代療法
14:44
of the vast world of alternative treatments.
359
872963
2925
抱有更加寬容的看法。
14:47
And I get letters, I get hundreds of letters
360
875888
2384
我收到來信，多達幾百封的來信。
14:50
from people writing to tell me
about what's worked for them.
about what's worked for them.
361
878272
2516
人們來信告訴我，什麼樣的療法對他們有效。
14:52
Someone was asking me backstage today
362
880788
2201
今天有人在後臺問我關於
14:54
about meditation.
363
882989
1463
藥物治療的事情。
14:56
My favorite of the letters that I got
364
884452
2465
我最喜歡的一封來信
14:58
was the one that came from a woman
365
886917
1474
是來自一位女士。
15:00
who wrote and said that she had tried therapy,
366
888391
2207
她說她嘗試過心理治療，
15:02
she had tried medication,
she had tried pretty much everything,
she had tried pretty much everything,
367
890598
2387
也嘗試過藥物治療，
嘗試了幾乎所有的治療方式。
嘗試了幾乎所有的治療方式。
15:04
and she had found a solution
and hoped I would tell the world,
and hoped I would tell the world,
368
892985
2837
她找到一個治療方法希望我能告訴全世界，
15:07
and that was making little things from yarn.
369
895822
3812
那就是用紗線做些小東西。
15:11
(Laughter)
370
899634
2999
（笑聲）
15:14
She sent me some of them. (Laughter)
371
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3524
她還寄給我一些她的作品。（笑聲）
15:18
And I'm not wearing them right now.
372
906157
3688
我今天並沒有把它們戴在身上，
15:21
I suggested to her that she also should look up
373
909845
2515
我建議她還應該去醫院，
15:24
obsessive compulsive disorder in the DSM.
374
912360
4048
檢查一下是否得了強迫症。
15:28
And yet, when I went to look
at alternative treatments,
at alternative treatments,
375
916408
3128
然而，當我去了解各種療法的時候，
15:31
I also gained perspective on other treatments.
376
919536
2908
我也對其它療法有了新看法。
15:34
I went through a tribal exorcism in Senegal
377
922444
2903
我在塞內加爾參加了一次部落驅魔，
15:37
that involved a great deal of ram's blood
378
925347
2013
裡面還有很多公羊的血，
15:39
and that I'm not going to detail right now,
379
927360
2062
這裡我就不描述細節了。
15:41
but a few years afterwards I was in Rwanda
380
929422
2000
但是多年之後，我在盧旺達
15:43
working on a different project,
381
931422
1758
做另一個計畫。
15:45
and I happened to describe
my experience to someone,
my experience to someone,
382
933180
2796
我湊巧把自己的經歷告訴某個人，
15:47
and he said, "Well, you know,
383
935976
1760
他說：「嗯，你知道，
15:49
that's West Africa, and we're in East Africa,
384
937736
1820
那裡是西非，我們這兒是東非，
15:51
and our rituals are in some ways very different,
385
939556
1834
我們的儀式在一些方面很不同，
15:53
but we do have some rituals that have something
386
941390
2013
不過我們確實有一些儀式
15:55
in common with what you're describing."
387
943403
1987
內容和你描述的相同。」
15:57
And I said, "Oh." And he said, "Yes," he said,
388
945390
1663
我回答說「哦。」然後他說：「是的。」
15:59
"but we've had a lot of trouble with
Western mental health workers,
Western mental health workers,
389
947053
2642
他又說：「不過西方的心理工作者
讓我們很苦惱，
讓我們很苦惱，
16:01
especially the ones who came
right after the genocide."
right after the genocide."
390
949695
2757
尤其是大屠殺之後來的那些心理醫生。」
16:04
And I said, "What kind of trouble did you have?"
391
952452
2327
我問：「你對他們有什麼意見嗎？」
16:06
And he said, "Well,
392
954779
1546
他回答：「嗯，
16:08
they would do this bizarre thing.
393
956325
2664
他們做一些古怪的事。
16:10
They didn't take people out in the sunshine
394
958989
1885
他們不帶人們去陽光下，
16:12
where you begin to feel better.
395
960874
1700
那裡才讓人感覺舒服。
16:14
They didn't include drumming or music
to get people's blood going.
to get people's blood going.
396
962574
3094
他們不用鼓聲或者音樂使人血脈沸騰，
16:17
They didn't involve the whole community.
397
965668
1842
他們不動員整個社區的人，
16:19
They didn't externalize the depression
398
967510
1775
他們不把憂鬱看做侵略性的幽靈
16:21
as an invasive spirit.
399
969285
1433
進行驅逐。
16:22
Instead what they did was they took people
400
970718
2631
相反的是，他們把人們一個個
16:25
one at a time into dingy little rooms
401
973349
2628
帶到昏暗的小屋子裡，
16:27
and had them talk for an hour
402
975977
1343
跟他們談上一個小時，
16:29
about bad things that had happened to them."
403
977320
2230
談論發生在他們身上的悲慘故事。」
16:31
(Laughter) (Applause)
404
979550
5460
（笑聲）（鼓掌）
16:37
He said, "We had to ask them to leave the country."
405
985010
2362
他說：「我們不得不要求他們離境。」
16:39
(Laughter)
406
987372
3057
（笑聲）
16:42
Now at the other end of alternative treatments,
407
990429
2444
談到另一種替代療法，
16:44
let me tell you about Frank Russakoff.
408
992873
2035
我和大家說說
法蘭克 (Frank Russakoff) 的故事。
法蘭克 (Frank Russakoff) 的故事。
16:46
Frank Russakoff had the worst depression
409
994908
3053
法蘭克得了非常糟糕的憂鬱症，
16:49
perhaps that I've ever seen in a man.
410
997961
2915
也許是我所見過最嚴重的病患。
16:52
He was constantly depressed.
411
1000876
1993
他一直處於憂鬱狀態。
16:54
He was, when I met him, at a point at which
412
1002869
2141
我遇到他時，
16:57
every month he would have electroshock treatment.
413
1005010
3158
他每個月都要接受電擊治療，
17:00
Then he would feel sort of disoriented for a week.
414
1008168
2575
之後一週他會感覺茫然迷惘，
17:02
Then he would feel okay for a week.
415
1010743
1803
下一週他會覺得舒服一些，
17:04
Then he would have a week of going downhill.
416
1012546
1700
再下週他就會墜入谷底，
17:06
And then he would have another
electroshock treatment.
electroshock treatment.
417
1014246
2685
那時他就會再做一次電擊治療。
17:08
And he said to me when I met him,
418
1016931
1415
我遇到他時，他告訴我：
17:10
"It's unbearable to go through my weeks this way.
419
1018346
2552
「我無法忍受這樣一週一週的循環。
17:12
I can't go on this way,
420
1020898
1507
我不能繼續這樣下去，
17:14
and I've figured out how I'm going to end it
421
1022405
2264
我已經想好了怎麼結束這一切，
17:16
if I don't get better.
422
1024669
1557
如果我不能好起來的話。
17:18
But," he said to me, "I heard about a protocol
423
1026226
2708
但是，我聽說在麻省總醫院
17:20
at Mass General for a procedure called
424
1028934
2223
有一項醫療實驗
叫做扣帶回切開術，是一種腦部手術，
17:23
a cingulotomy, which is a brain surgery,
425
1031157
2026
17:25
and I think I'm going to give that a try."
426
1033183
2571
我想去試試看。」
我記得當時自己很吃驚，
17:27
And I remember being amazed at that point
427
1035754
1954
17:29
to think that someone
428
1037708
1300
想到他這個人
17:31
who clearly had so many bad experiences
429
1039008
3221
有過那麼多悲慘的經歷，
17:34
with so many different treatments
430
1042229
1859
用了那麼多不同的療法，
17:36
still had buried in him somewhere enough optimism
431
1044088
3122
在他內心某處依然懷有一種樂觀天性，
17:39
to reach out for one more.
432
1047210
2550
支撐著他再試一次。
17:41
And he had the cingulotomy,
433
1049760
2180
他做了扣帶回切開手術，
17:43
and it was incredibly successful.
434
1051940
2041
出乎意料地成功。
17:45
He's now a friend of mine.
435
1053981
1493
他現在是我的朋友，
17:47
He has a lovely wife and two beautiful children.
436
1055474
3492
有一個可愛的妻子和兩個漂亮的孩子。
17:50
He wrote me a letter the Christmas after the surgery,
437
1058966
2949
術後的聖誕節他寫了一封信給我，
17:53
and he said,
438
1061915
1189
他說：
17:55
"My father sent me two presents this year,
439
1063104
2407
「今年我父親寄了兩個聖誕禮物給我，
17:57
First, a motorized C.D. rack from The Sharper Image
440
1065511
2602
第一個禮物是夏珀影像的
唱片電動收藏架。
唱片電動收藏架。
18:00
that I didn't really need,
441
1068113
1421
我並不很需要這個，
18:01
but I knew he was giving it to me to celebrate
442
1069534
2097
但是我明白，他送我這個是為了
18:03
the fact that I'm living on my own
443
1071631
1728
慶祝我獨立生活，
18:05
and have a job I seem to love.
444
1073359
2047
並且有了一份自己還算喜歡的工作。
18:07
And the other present
445
1075406
1561
另一份禮物
18:08
was a photo of my grandmother,
446
1076967
1576
是一張我祖母的照片。
18:10
who committed suicide.
447
1078543
2252
我祖母是自殺去世的。
18:12
As I unwrapped it, I began to cry,
448
1080795
2935
當我拆開包裝的時候，我哭了。
18:15
and my mother came over and said,
449
1083730
1880
我母親走過來問我：
18:17
'Are you crying because of the
relatives you never knew?'
relatives you never knew?'
450
1085610
3315
「你是因為沒有見過她才哭的嗎？」
18:20
And I said, 'She had the same disease I have.'
451
1088925
4088
我回答：「我哭是因為
她得了跟我一樣的病。」
她得了跟我一樣的病。」
18:25
I'm crying now as I write to you.
452
1093013
2581
寫給你這封信的時候，我正在流淚。
18:27
It's not that I'm so sad, but I get overwhelmed,
453
1095594
3595
不是因為悲傷，而是我無法承受。
18:31
I think, because I could have killed myself,
454
1099189
2221
我想我差點就會自殺，
18:33
but my parents kept me going,
455
1101410
1703
但是我的父母讓我挺過來了，
18:35
and so did the doctors,
456
1103113
1749
還有醫生們也幫助我，
18:36
and I had the surgery.
457
1104862
1854
讓我做了手術。
18:38
I'm alive and grateful.
458
1106716
2815
我活了下來，充滿感激。
18:41
We live in the right time,
459
1109531
2260
我生在一個美好的時代，
18:43
even if it doesn't always feel like it."
460
1111791
3879
雖然不是每時每刻感覺都美好。」
18:47
I was struck by the fact that depression
461
1115670
1897
讓我震驚的是，憂鬱症廣泛地
18:49
is broadly perceived to be
462
1117567
1725
被看做是一種
18:51
a modern, Western, middle-class thing,
463
1119292
3537
現代西方世界中產階級的產物。
18:54
and I went to look at how it operated
464
1122829
2152
於是我開始觀察憂鬱症
18:56
in a variety of other contexts,
465
1124981
2003
在不同情境下的表現方式。
18:58
and one of the things I was most interested in
466
1126984
2119
其中我最感興趣的是
19:01
was depression among the indigent.
467
1129103
1790
生活貧苦的憂鬱症患者。
19:02
And so I went out to try to look at
468
1130893
1781
所以我開始嘗試研究，
19:04
what was being done for
poor people with depression.
poor people with depression.
469
1132674
2580
了解窮人如何治療憂鬱症。
19:07
And what I discovered is that poor people
470
1135254
2158
我發現窮人
19:09
are mostly not being treated for depression.
471
1137412
2557
幾乎都沒有得到憂鬱症的治療。
19:11
Depression is the result of a genetic vulnerability,
472
1139969
2919
憂鬱症是一種基因缺陷，
19:14
which is presumably evenly
distributed in the population,
distributed in the population,
473
1142888
3158
它大致上平均分佈於人群中。
19:18
and triggering circumstances,
474
1146046
1953
在窮人身上，
19:19
which are likely to be more severe
475
1147999
1903
憂鬱症的情況
可能會更為嚴重。
19:21
for people who are impoverished.
476
1149902
1875
19:23
And yet it turns out that if you have
477
1151777
2427
然而如果你有美好的人生，
19:26
a really lovely life but feel miserable all the time,
478
1154204
2140
但卻總是不開心，
19:28
you think, "Why do I feel like this?
479
1156344
2000
你會想：「我為什麼感到不開心？
19:30
I must have depression."
480
1158344
1669
我肯定是憂鬱了。」
19:32
And you set out to find treatment for it.
481
1160013
1923
於是你到處尋找治療方法。
19:33
But if you have a perfectly awful life,
482
1161936
2093
但是如果你的生活一團糟，
19:36
and you feel miserable all the time,
483
1164029
1867
你總是感到不開心，
19:37
the way you feel is commensurate with your life,
484
1165896
2826
那麼你的感受和生活狀態是相符的。
19:40
and it doesn't occur to you to think,
485
1168722
1724
你就不會想：
19:42
"Maybe this is treatable."
486
1170446
1783
「也許這病醫得好。」
19:44
And so we have an epidemic in this country
487
1172229
3136
所以我們國家的低收入人群中，
19:47
of depression among impoverished people
488
1175365
2913
憂鬱症像傳染病一樣到處蔓延，
19:50
that's not being picked up
and that's not being treated
and that's not being treated
489
1178278
2512
卻沒有被關注和治療。
19:52
and that's not being addressed,
490
1180790
2056
這個問題一直沒有解決，
19:54
and it's a tragedy of a grand order.
491
1182846
2200
變成了一個巨大的悲劇。
19:57
And so I found an academic
492
1185046
1488
我找到一位學者，
19:58
who was doing a research project
493
1186534
1817
她在華盛頓特區外圍的貧民窟裡
20:00
in slums outside of D.C.,
494
1188351
1741
進行一項研究。
20:02
where she picked up women who had
come in for other health problems
come in for other health problems
495
1190092
2997
她挑出一些因為患其它疾病而就醫的女性，
20:05
and diagnosed them with depression,
496
1193089
1779
診斷出她們有憂鬱症後，
20:06
and then provided six months
of the experimental protocol.
of the experimental protocol.
497
1194868
3266
為她們提供了六個月的實驗計劃。
20:10
One of them, Lolly, came in,
498
1198134
2329
其中的一位叫羅莉，
20:12
and this is what she said the day she came in.
499
1200463
2297
這是她第一天來看病時的陳述。
20:14
She said, and she was a woman, by the way,
500
1202760
3395
她是一位女性，順帶一提。
20:18
who had seven children. She said,
501
1206155
2092
她有七個孩子，她說：
20:20
"I used to have a job but I had to give it up because
502
1208247
2651
「我以前有份工作，但是我不得不辭職。
20:22
I couldn't go out of the house.
503
1210898
2060
因為我無法走出家門。
20:24
I have nothing to say to my children.
504
1212958
2228
我和我的孩子無話可說，
20:27
In the morning, I can't wait for them to leave,
505
1215186
2767
早上，我巴不得他們都快點離開上學去。
20:29
and then I climb in bed and
pull the covers over my head,
pull the covers over my head,
506
1217953
2990
然後我就爬到床上，用被子蒙住腦袋。
20:32
and three o'clock when they come home,
507
1220943
1646
下午三點他們就回家了，
20:34
it just comes so fast."
508
1222589
1801
時間過得超快。」
20:36
She said, "I've been taking a lot of Tylenol,
509
1224390
2240
她說：「我已經吃了很多泰諾，
20:38
anything I can take so that I can sleep more.
510
1226630
2759
吃各種藥，好讓自己多睡一會。
20:41
My husband has been telling me I'm stupid, I'm ugly.
511
1229389
3770
我丈夫一直說我又蠢又醜。
20:45
I wish I could stop the pain."
512
1233159
3505
我希望能停止痛苦。」
20:48
Well, she was brought into
this experimental protocol,
this experimental protocol,
513
1236664
2640
她後來被加入到實驗治療計劃。
20:51
and when I interviewed her six months later,
514
1239304
2308
六個月之後我採訪了她，
20:53
she had taken a job working in childcare
515
1241612
4407
她已經在美國海軍幼兒園工作，
20:58
for the U.S. Navy, she had left the abusive husband,
516
1246019
3805
她離開了虐待她的丈夫。
21:01
and she said to me,
517
1249824
2082
她對我說：
21:03
"My kids are so much happier now."
518
1251906
2369
「我的孩子們現在開心多了。」
21:06
She said, "There's one room in my new place
519
1254275
1977
還說：「我的新家裡
21:08
for the boys and one room for the girls,
520
1256252
2608
有一間房間給男孩子，一間房間給女孩子，
21:10
but at night, they're just all up on my bed,
521
1258860
2539
但是到了晚上，他們都會來到我的床頭。
21:13
and we're doing homework
all together and everything.
all together and everything.
522
1261399
2612
我們一起做功課，一起做每件事。
21:16
One of them wants to be a preacher,
523
1264011
1673
我有個兒子想當牧師，
21:17
one of them wants to be a firefighter,
524
1265684
1700
還有一個兒子想做個消防員，
21:19
and one of the girls says she's going to be a lawyer.
525
1267384
2966
其中一個女兒說她以後會當個律師。
21:22
They don't cry like they used to,
526
1270350
2005
他們不再像過去一樣哭泣，
21:24
and they don't fight like they did.
527
1272355
2558
也不像過去一樣打架。
21:26
That's all I need now is my kids.
528
1274913
3780
如今我只需要我的孩子們就夠了。
21:30
Things keep on changing,
529
1278693
1912
一切都不斷變化，
21:32
the way I dress, the way I feel, the way I act.
530
1280605
5193
我的穿著、我的情緒、我的行為都變了。
21:37
I can go outside not being afraid anymore,
531
1285798
3687
我不再畏懼出門，
21:41
and I don't think those bad feelings are coming back,
532
1289485
3409
我想那些壞情緒再也不會回來了。
21:44
and if it weren't for Dr. Miranda and that,
533
1292894
3035
這多虧了米蘭達醫生。
21:47
I would still be at home with
the covers pulled over my head,
the covers pulled over my head,
534
1295929
3617
不然我還待在家裡蒙頭大睡。
21:51
if I were still alive at all.
535
1299546
2349
前提是我還活著。
21:53
I asked the Lord to send me an angel,
536
1301895
3732
我向上帝禱告，賜我一個天使吧，
21:57
and he heard my prayers."
537
1305627
4330
衪真的聽到了我的祈禱。」
22:01
I was really moved by these experiences,
538
1309959
3353
我真的被這些經歷深深打動。
22:05
and I decided that I wanted to write about them
539
1313312
2539
我決定寫下這些，
22:07
not only in a book I was working on,
540
1315851
1379
不僅僅寫在我的書中，
22:09
but also in an article,
541
1317230
1311
還要寫一篇文章。
22:10
and so I got a commission from
The New York Times Magazine
The New York Times Magazine
542
1318541
2321
我從紐約時代雜誌得到一份約稿，
22:12
to write about depression among the indigent.
543
1320862
2016
寫寫低收入者的憂鬱情況。
22:14
And I turned in my story,
544
1322878
1616
我交出了稿件，
22:16
and my editor called me and said,
545
1324494
1596
我的編輯打電話告訴我：
22:18
"We really can't publish this."
546
1326090
1710
「我們可不能發表這個。」
22:19
And I said, "Why not?"
547
1327800
1750
我問：「為什麼不行？」
22:21
And she said, "It just is too far-fetched.
548
1329550
2305
她回答說：「這故事太勉強了。
22:23
These people who are sort of at
the very bottom rung of society
the very bottom rung of society
549
1331855
3778
這些人處於社會最底層，
22:27
and then they get a few months of treatment
550
1335633
1704
然後他們接受了幾個月的治療，
22:29
and they're virtually ready to run Morgan Stanley?
551
1337337
2632
接著就能去管理摩根斯坦利了？
（Morgan Stanley：知名投資公司）
（Morgan Stanley：知名投資公司）
22:31
It's just too implausible."
552
1339969
1854
這太沒說服力了。」
22:33
She said, I've never even heard of anything like it."
553
1341823
2205
她說：「我從來沒聽過這種事情。」
22:36
And I said, "The fact that you've never heard of it
554
1344028
2534
我回答：「你沒有聽過這樣的事情，
22:38
is an indication that it is news."
555
1346562
3000
正說明了這是條新聞。」
22:41
(Laughter) (Applause)
556
1349562
6134
（笑聲）（掌聲）
22:49
"And you are a news magazine."
557
1357317
2494
「而你們可是一家新聞雜誌社。」
22:51
So after a certain amount of negotiation,
558
1359811
1982
經過一些交涉協商，
22:53
they agreed to it.
559
1361793
1241
他們同意發表。
22:55
But I think a lot of what they said
560
1363034
1615
之後我想了很多，雜誌社的想法
22:56
was connected in some strange way
561
1364649
2295
在某個詭異的層面上
跟另一個觀點雷同，
跟另一個觀點雷同，
22:58
to this distaste that people still have
562
1366944
2142
即人們依然對治療憂鬱症
23:01
for the idea of treatment,
563
1369086
1463
覺得反感。
23:02
the notion that somehow if we went out
564
1370549
1882
如果我們去貧窮地區
23:04
and treated a lot of people in indigent communities,
565
1372431
2696
大規模治療人們的憂鬱症，
23:07
that would be an exploitative thing to do,
566
1375127
1898
這會是一件具有剝削意義的事情，
23:09
because we would be changing them.
567
1377025
1642
因為我們將會改造他們。
23:10
There is this false moral imperative
568
1378667
2033
似乎所有的人
23:12
that seems to be all around us
569
1380700
1789
都有一種錯誤的道德約束，
23:14
that treatment of depression,
570
1382489
2354
認為憂鬱症的治療，
23:16
the medications and so on, are an artifice,
571
1384843
2299
包括藥物和其他治療，都是人工的、
23:19
and that it's not natural.
572
1387142
2172
而不是自然的過程。
23:21
And I think that's very misguided.
573
1389314
2849
我想這想法是非常誤導人的。
23:24
It would be natural for people's teeth to fall out,
574
1392163
3532
按照自然規律，
人的牙齒應該逐漸掉落，
人的牙齒應該逐漸掉落，
23:27
but there is nobody militating against toothpaste,
575
1395695
3330
但是沒人會反對使用牙膏，
23:31
at least not in my circles.
576
1399025
2128
至少我身邊沒人反對。
23:33
And people then say, "Well, but isn't depression
577
1401153
2502
接著人們會說：「那麼，
憂鬱症難道不是人們應該經歷的過程嗎？
23:35
part of what people are supposed to experience?
578
1403655
2185
23:37
Didn't we evolve to have depression?
579
1405840
1741
憂鬱難道不是我們演化的結果嗎？
23:39
Isn't it part of your personality?"
580
1407581
1907
它不是個性的一部分嗎？」
23:41
To which I would say, mood is adaptive.
581
1409488
2746
對此我想說的是，
情緒是可以適應調整的。
情緒是可以適應調整的。
23:44
Being able to have sadness and fear
582
1412234
3329
我們能夠感受悲傷、害怕、
23:47
and joy and pleasure
583
1415563
1842
快樂、愉悅，
23:49
and all of the other moods that we have,
584
1417405
1803
和其它所有的情緒，
23:51
that's incredibly valuable.
585
1419208
2064
這彌足珍貴。
23:53
And major depression is something that happens
586
1421272
3047
當這個感覺系統失靈的時候，
23:56
when that system gets broken.
587
1424319
2012
嚴重的憂鬱症就出現了，
23:58
It's maladaptive.
588
1426331
1717
這是情緒上無法適應。
24:00
People will come to me and say,
589
1428048
1572
人們來找我，跟我說：
24:01
"I think, though, if I just stick it out for another year,
590
1429620
2768
「即使如此，我想如果能再堅持一年，
24:04
I think I can just get through this."
591
1432388
2076
我就能好起來。」
24:06
And I always say to them, "You may get through it,
592
1434464
2303
我總是這樣回答他們：
「你可能會好起來，
「你可能會好起來，
24:08
but you'll never be 37 again.
593
1436767
2709
但是你的 37 歲無法再來一次。
24:11
Life is short, and that's a whole year
594
1439476
2550
人生短暫，你打算放棄
24:14
you're talking about giving up.
595
1442026
1956
這整整一年，
24:15
Think it through."
596
1443982
1538
你再想想吧。」
24:17
It's a strange poverty of the English language,
597
1445520
2846
英語其實貧瘠得有點怪，
24:20
and indeed of many other languages,
598
1448366
2108
實際上很多其它語言也是如此，
24:22
that we use this same word, depression,
599
1450474
2218
我們用同一個詞（depression：沮喪）
24:24
to describe how a kid feels
600
1452692
1805
來形容小孩在
過生日那天碰到下雨的心情。
24:26
when it rains on his birthday,
601
1454497
1712
24:28
and to describe how somebody feels
602
1456209
2528
同時也用這個詞來形容人們
24:30
the minute before they commit suicide.
603
1458737
2454
自殺前一分鐘的心情。
24:33
People say to me, "Well, is it
continuous with normal sadness?"
continuous with normal sadness?"
604
1461191
3105
人們問我：「那麼，憂鬱是不是連續的悲傷？」
24:36
And I say, in a way it's continuous
with normal sadness.
with normal sadness.
605
1464296
3144
我回答在某種意義上，
憂鬱就是長時間的悲傷。
憂鬱就是長時間的悲傷。
24:39
There is a certain amount of continuity,
606
1467440
2200
悲傷和憂鬱之間有一定的連續性。
24:41
but it's the same way there's continuity
607
1469640
1957
但是兩者的連續性，就像是
24:43
between having an iron fence outside your house
608
1471597
1987
悲傷就像是你家院子裡的鐵柵欄
24:45
that gets a little rust spot
609
1473584
1677
有點鏽斑，
24:47
that you have to sand off and do a little repainting,
610
1475261
2746
於是你必須打砂紙和重新上點漆。
24:50
and what happens if you leave
the house for 100 years
the house for 100 years
611
1478007
2647
憂鬱則像是如果你離家 100 年之後，
24:52
and it rusts through until it's only a pile
612
1480654
2898
鐵柵欄從裡到外鏽到只剩下
一堆橘色粉末。
24:55
of orange dust.
613
1483552
1234
24:56
And it's that orange dust spot,
614
1484786
2173
而就是那堆橘色粉末，
24:58
that orange dust problem,
615
1486959
1789
那堆橘色的麻煩
25:00
that's the one we're setting out to address.
616
1488748
2989
就是我們要解決的問題。
25:03
So now people say,
617
1491737
2240
所以現在人們問：
25:05
"You take these happy pills, and do you feel happy?"
618
1493977
2731
「你吃了那些讓你快樂的藥，感覺開心嗎？」
25:08
And I don't.
619
1496708
1886
不，我不會開心。
25:10
But I don't feel sad about having to eat lunch,
620
1498594
2822
但是我不再為了得吃午飯而沮喪，
25:13
and I don't feel sad about my answering machine,
621
1501416
2836
不再因為電話答錄機而難過，
25:16
and I don't feel sad about taking a shower.
622
1504252
2845
也不會因為要洗澡而煩惱。
25:19
I feel more, in fact, I think,
623
1507097
2854
實際上，我想我能感受到更多。
25:21
because I can feel sadness without nullity.
624
1509951
2430
因為我可以感覺到傷心，但不空虛。
25:24
I feel sad about professional disappointments,
625
1512381
4347
我因為工作上的不順心而難過，
25:28
about damaged relationships,
626
1516728
2347
因為破碎的愛情而傷心，
25:31
about global warming.
627
1519075
2039
因為全球暖化而傷心，
25:33
Those are the things that I feel sad about now.
628
1521114
2725
現在這些事情讓我感到悲傷。
25:35
And I said to myself, well, what is the conclusion?
629
1523839
2734
我問自己，那麼結論是什麼呢？
25:38
How did those people who have better lives
630
1526573
2561
那些生活優渥、
病情更加嚴重的憂鬱症患者
病情更加嚴重的憂鬱症患者
25:41
even with bigger depression manage to get through?
631
1529134
2554
是怎麼熬過去的？
25:43
What is the mechanism of resilience?
632
1531688
2797
挺過去的方法是什麼呢？
25:46
And what I came up with over time
633
1534485
2084
時間流逝，我想到的是，
25:48
was that the people who deny their experience,
634
1536569
2916
那些否定自己經歷的人，
25:51
the ones who say, "I was depressed a long time ago
635
1539485
2032
他們會說：「很久以前我憂鬱了。
25:53
and I never want to think about it again
636
1541517
1737
我不想再想那些經歷，
25:55
and I'm not going to look at it
637
1543254
1242
我不想再看它，
25:56
and I'm just going to get on with my life,"
638
1544496
1890
我只想繼續我的生活。」
25:58
ironically, those are the people
639
1546386
1959
諷刺的是，那些人
26:00
who are most enslaved by what they have.
640
1548345
2698
往往被自己的經歷所困。
26:03
Shutting out the depression strengthens it.
641
1551043
2564
迴避憂鬱只會讓它更強大。
26:05
While you hide from it, it grows.
642
1553607
3280
越逃離，它就越強大。
26:08
And the people who do better
643
1556887
2860
能夠好起來的人，
26:11
are the ones who are able to tolerate the fact
644
1559747
2599
他們能夠接受事實，
26:14
that they have this condition.
645
1562346
1622
承認自己的症狀。
26:15
Those who can tolerate their depression
646
1563968
2470
那些可以接納自己有憂鬱症的人
26:18
are the ones who achieve resilience.
647
1566438
1782
會康復起來。
26:20
So Frank Russakoff said to me,
648
1568220
1783
法蘭克後來告訴我：
26:22
"If I had it again to do over,
649
1570003
1516
「如果一切從頭來過，
26:23
I suppose I wouldn't do it this way,
650
1571519
2137
我想我不會這樣做，
26:25
but in a strange way, I'm grateful
651
1573656
1964
但是很奇怪，我對自己的經歷
26:27
for what I've experienced.
652
1575620
1503
非常感激。
26:29
I'm glad to have been in the hospital 40 times.
653
1577123
3817
我很高興自己住了 40 次醫院，
26:32
It taught me so much about love,
654
1580940
2603
這些經歷教會了我什麼是愛，
26:35
and my relationship with my parents and my doctors
655
1583543
2840
我和父母、醫生之間的關係
26:38
has been so precious to me, and will be always."
656
1586383
4389
對我而言非常珍貴，一輩子都受用。」
26:42
And Maggie Robbins said,
657
1590772
1926
瑪姬曾說：
26:44
"I used to volunteer in an AIDS clinic,
658
1592698
2989
「我以前在愛滋診所裡擔任志工。
26:47
and I would just talk and talk and talk,
659
1595687
3014
我會滔滔不絕地
26:50
and the people I was dealing with
660
1598701
1813
對著我負責的病患說話。
26:52
weren't very responsive, and I thought,
661
1600514
2067
他們沒太大反應，於是我想：
26:54
'That's not very friendly or helpful of them.'
662
1602581
3961
「他們真不友善，也不配合。」
26:58
And then I realized,
663
1606542
1642
後來我意識到，
27:00
I realized that they weren't going to do more
664
1608184
2127
我意識到他們無法做到更多，
27:02
than make those first few minutes of small talk.
665
1610311
2387
除了完成剛開始那幾分鐘的閒談。
27:04
It was simply going to be an occasion
666
1612698
2057
這只是一個機會，讓他們看到，
27:06
where I didn't have AIDS and I wasn't dying,
667
1614755
2878
雖然我沒有愛滋病，也不會死去，
27:09
but could tolerate the fact that they did
668
1617633
2973
但是我可以接受他們的疾病，
27:12
and they were.
669
1620606
1787
還有他們正在死去的事實。
27:14
Our needs are our greatest assets.
670
1622393
3603
我們的需求是我們最寶貴的財富。
27:17
It turns out I've learned to give
671
1625996
2139
我發現自己學會了付出
27:20
all the things I need."
672
1628135
4025
自己擁有的一切。」
27:24
Valuing one's depression
673
1632160
1691
正視憂鬱的價值
27:25
does not prevent a relapse,
674
1633851
2194
不能防止憂鬱的復發，
27:28
but it may make the prospect of relapse
675
1636045
2661
但是可能會使復發的結果好一些，
27:30
and even relapse itself easier to tolerate.
676
1638706
4218
甚至能讓自己更容易熬過去。
27:34
The question is not so much
677
1642924
2045
問題並不在於
27:36
of finding great meaning and deciding
678
1644969
2175
找尋重大的意義，或者判斷
27:39
your depression has been very meaningful.
679
1647144
2027
你的憂鬱是否很有意義。
27:41
It's of seeking that meaning
680
1649171
2171
而是當憂鬱捲土重來的時候，
27:43
and thinking, when it comes again,
681
1651342
1804
尋找它的意義，並想：
27:45
"This will be hellish,
682
1653146
1640
「這會很可怕，
27:46
but I will learn something from it."
683
1654786
2701
但是我會從中獲益。」
27:49
I have learned in my own depression
684
1657487
2264
我從自己的憂鬱中學到，
27:51
how big an emotion can be,
685
1659751
2013
情緒的力量有多大，
27:53
how it can be more real than facts,
686
1661764
3097
它甚至可以比事實更加真實。
27:56
and I have found that that experience
687
1664861
2949
我也發現那些經歷
27:59
has allowed me to experience positive emotion
688
1667810
2892
用一種更為強烈和聚焦的方式
28:02
in a more intense and more focused way.
689
1670702
3520
讓我經歷正向的情緒。
28:06
The opposite of depression is not happiness,
690
1674222
3487
憂鬱的反面不是快樂，
28:09
but vitality,
691
1677709
1454
而是活力。
28:11
and these days, my life is vital,
692
1679163
2741
現在，我的生活充滿活力，
28:13
even on the days when I'm sad.
693
1681904
2745
即使在我感到難過的時候也是如此。
28:16
I felt that funeral in my brain,
694
1684649
3313
我曾在腦中感受到那場葬禮，
28:19
and I sat next to the colossus
695
1687962
2024
我坐在一個巨人身邊，
28:21
at the edge of the world,
696
1689986
2247
就在世界的邊緣，
28:24
and I have discovered
697
1692233
2089
我發現我的體內
28:26
something inside of myself
698
1694322
1851
有個東西，
28:28
that I would have to call a soul
699
1696173
2133
我稱之為靈魂。
28:30
that I had never formulated
until that day 20 years ago
until that day 20 years ago
700
1698306
3756
20 年前它從未成型，
28:34
when hell came to pay me a surprise visit.
701
1702062
4518
直到地獄冷不防地拜訪我。
28:38
I think that while I hated being depressed
702
1706580
4098
我想即使我痛恨自己的憂鬱，
28:42
and would hate to be depressed again,
703
1710678
2334
痛恨又被憂鬱纏上，
28:45
I've found a way to love my depression.
704
1713012
2744
我還是找到了一種方法讓自己愛上它。
28:47
I love it because it has forced me
705
1715756
2025
我愛自己的憂鬱，因為它迫使我
28:49
to find and cling to joy.
706
1717781
2769
尋找和抓緊快樂。
28:52
I love it because each day I decide,
707
1720550
3488
我愛我的憂鬱，因為每天，我都決定
28:56
sometimes gamely,
708
1724038
1540
去抓住活下去的理由。
28:57
and sometimes against the moment's reason,
709
1725578
2698
雖然有時候不拘小節，
29:00
to cleave to the reasons for living.
710
1728276
2578
有時候不合時宜。
29:02
And that, I think, is a highly privileged rapture.
711
1730854
4123
我想，這真是天賜的無上喜悅。
29:06
Thank you.
712
1734977
3983
謝謝大家。
29:10
(Applause)
713
1738960
3136
（掌聲）
ABOUT THE SPEAKER
Andrew Solomon - WriterAndrew Solomon writes about politics, culture and psychology.
Why you should listen
Andrew Solomon is a writer, lecturer and Professor of Clinical Psychology at Columbia University. He is president of PEN American Center. He writes regularly for The New Yorker and the New York Times.
Solomon's newest book, Far and Away: Reporting from the Brink of Change, Seven Continents, Twenty-Five Years was published in April, 2016. His previous book, Far From the Tree: Parents, Children, and the Search for Identity won the National Book Critics Circle award for nonfiction, the Wellcome Prize and 22 other national awards. It tells the stories of parents who not only learn to deal with their exceptional children but also find profound meaning in doing so. It was a New York Times bestseller in both hardcover and paperback editions. Solomon's previous book, The Noonday Demon: An Atlas of Depression, won the 2001 National Book Award for Nonfiction, was a finalist for the 2002 Pulitzer Prize and was included in The Times of London's list of one hundred best books of the decade. It has been published in twenty-four languages. Solomon is also the author of the novel A Stone Boat and of The Irony Tower: Soviet Artists in a Time of Glasnost.
Solomon is an activist in LGBT rights, mental health, education and the arts. He is a member of the boards of directors of the National LGBTQ Force and Trans Youth Family Allies. He is a member of the Board of Visitors of Columbia University Medical Center, serves on the National Advisory Board of the Depression Center at the University of Michigan, is a director of Columbia Psychiatry and is a member of the Advisory Board of the Depression and Bipolar Support Alliance. Solomon also serves on the boards of the Metropolitan Museum of Art, Yaddo and The Alex Fund, which supports the education of Romani children. He is also a fellow of Berkeley College at Yale University and a member of the New York Institute for the Humanities and the Council on Foreign Relations.
Solomon lives with his husband and son in New York and London and is a dual national. He also has a daughter with a college friend; mother and daughter live in Texas but visit often.
Andrew Solomon | Speaker | TED.com